Anesthesia Coding Alert
Choose the Correct Code by Identifying the Exact Nerve Blocked
Question: Some of our physicians are telling us that popliteal blocks are technically sciatic blocks and should be coded as such. What do we code for this kind of block? Texas Subscriber Answer: While technically correct, this description can be very confusing to coders. Tell your physicians that proper reporting hinges on them documenting the specific nerve being targeted. If they are targeting the sciatic nerve, their documentation should indicate a sciatic block, not popliteal, making 64445 (Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve …) the correct code, with a work relative value unit (RVU) of 1.39. CPT® does not include a code for popliteal block, so some coders assign 64450 (Injection(s), anesthetic agent(s) and/ or steroid; other peripheral nerve or branch) for procedures documented as such. However, 64450 only has an RVU of 0.75, and reporting it due to an inexact description in the medical record may cause the service to be undervalued. If popliteal is the only anatomical information given, ask your provider which nerve was being targeted, and that should lead you to the right code.
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